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June 24th, 2014
06:14 PM ET
Do I need a 3-D mammogram?Digital breast tomosynthesis, better known as 3-D mammography, can find more invasive, and in some cases more dangerous, cancers than a traditional digital mammogram, a new study published in the Journal of the American Medical Association this week concludes. But do you need one? Approved by the Food and Drug Administration in 2011 as a supplement to digital mammography, tomosynthesis creates a 3-D reconstruction of the breast tissue, giving radiologists a clearer view of overlapping slices. This new study found using the combination of digital and 3-D mammography reduces false alarms and unnecessary call backs by 15% in all groups of patients, including younger women and women with dense breast tissue. The study was funded by Hologic, the manufacturer of the 3-D imaging machine, and the National Cancer Institute. "3-D mammography finds more clinically significant breast cancers earlier... so that women have more treatment options and ultimately better health outcomes," said Dr. Emily F. Conant, senior author of the new study and chief of breast imaging in the Department of Radiology at the Perelman School of Medicine at the University of Pennsylvania. Unfortunately, 3-D mammography images cost more and are not yet available everywhere. Depending on where a woman lives and her insurance, tomosynthesis may or may not be covered. Robert Smith, senior director of cancer screening at the American Cancer Society, says the decision of whether to spring for the 3-D test is best left up to physicians to decide with their patients. But women should know that these images result in more detection of abnormal cells and therefore, more biopsies, he says. Experts believe women with dense breast tissue and women who may have scar tissue from breast surgery or biopsies can benefit most from the accuracy of 3-D mammograms. For women who can’t afford the extra fee, or who simply ask, "Is it worth it?" Smith says a standard digital mammogram is fine. The best thing for women to do is strictly follow recommendations for regular mammograms at an imaging center that has mammography experts on hand. Getting regular mammograms enables your doctor to easily compare your current images with previous scans, which can reduce false-positive test results. Smith predicts the decision will eventually be made for women as 3-D mammography becomes offered more widely, ultimately replacing standard mammography. Until then he says, “The jury is still out and the attorney for one side is feeling more confident than the other.”
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  About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love. Recent Comments
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Because I paid $50 extra for a 3D mammogram, it saved my life. A tumor was detected which, according to my doctor, would most likely not have been detected through a regular mammogram. Thanks to the 3D imaging, my breast cancer was caught early at Stage 2A. I'm only 41, but have been getting annual mammograms since age 35 due to family history. Once the 3D imaging was available in my area 3 years ago, I started paying the extra fee. I firmly believe it is the reason my cancer was caught early and has made it survivable. Insurance should pay for the 3D imaging, especially for women with a strong family history.
The best thing to do is to learn about your options. Ask your doctor about your options. There are alternatives like Molecular Breast Imaging out there that can be complementary to Mammography and Tomography. Dense breast tissue is also important to learn about as Mammography is not always an effective screening tool.
Am important point that was not touched upon is the additional amount of radiation the 3D mammogram exposes women to compared to a standard mammogram. I was hoping your article would discuss that so women could have the whole story. You covered the pros fantastically–where are the cons?
They did discuss the cons, including some increased radiation, cost, and the uncertainty as to whether catching bad cancers earlier makes a difference.
Can't afford health care? Mammograms are provided free for people with zero income through most county health programs, so you might try looking into that. And now that the affordable health care act is in place you should be able to get health care no matter what your income situation. I was without health care for eight years before the act went through and now have been able to get base line mammograms and pap smears at no cost because they are considered 'preventative' which is covered 100% by the insurance company. Maybe you could look into some of these options if you really want a mammogram…but I suspect you are a trolling male.
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